Keywords:
Ischaemia / Infarction, Contrast agent-intravenous, MR-Diffusion/Perfusion, MR, Cardiac
Authors:
E. cannizzaro, P. Palumbo, L. Panebianco, F. Bruno, L. Patriarca, R. Masi, E. Di Cesare, C. Masciocchi; L'Aquila/IT
Purpose
Coronary Artery Disease (CAD) is a multifactorial disease and its prevalence and incidence have been difficult to assess,
depending on the definition that has been used1.
In fact,
while in the past it was used to consider CAD as a disease due to narrowings of ≥50% in the left main coronary artery or in the proximal tract of LAD and ≥70% in one or several of the major coronary arteries,
nowadays understending and considerations about CAD are considerably different.
So,
up to now,
some authors include also microvascular dysfunction and coronary vasospasm in CAD definition1.
In any case,
CAD is the leading cause of death2 and its early diagnosis remains the main target of the medical approach to this disease.
Cardiac ischaemic pain (angina) is the most common symptom of CAD.
It’s longstanding knowed how angina is related to increas of ischemic metabolites3,
but in the ischaemia temporal sequence,
electocardiographics changes and angina occur at the end of sequence,
while signs of ventricular dysfunction with regional wall motion abnormalities occur earlier.
This sequence explains why imaging techniques based on perfusion,
metabolism or wall motion are more sensitive than an ECG or symptoms in detecting ischaemia1.
Cardiac Magnetic Resonance (CMR) has a primary role in the clinical,
preclinical and prognostic assessment of CAD4,
allowing accurate informations about perfusion,
myocardial contractility and motility,
and identification of necrotic area.
CMR is recognised as first class of study of ischemic heart diasease,
acute as well as cronic5.
The aim of our study was to assess myocardial perfusion during and after adenosine infusion in coronary artery disease (CAD) patients,
and compare different CMR sequences (perfusion,
LGE,
T1 mapping and ECV) in order to study their different capability in identification of pathologic myocardial changes in patients with knowed CAD.